NPI | 1275851784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19824) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F336171-1) |
Enumeration Date | 2010-05-07 |
Last Update Date | 2021-05-07 |